Implementation of nursing process in clinical settings: the case of three governmental hospitals in Ethiopia, 2017

Effect of standardized patient simulation-based pedagogics embedded with lecture in enhancing mental status evaluation cognition among nursing students in Tanzania: A longitudinal quasi-experimental study

BACKGROUND

Nurses around the world are expected to demonstrate competence in performing mental status evaluation. However, there is a gap between what is taught in class and what is practiced for patients with mental illness among nursing students during MSE performance. It is believed that proper pedagogics may enhance this competence. A longitudinal controlled quasi-experimental study design was used to evaluate the effect of using standardized patient simulation-based pedagogics embedded with a lecture in enhancing mental status evaluation cognition among nursing students in Tanzania.

METHODS

A longitudinal controlled quasi-experimental study design with pre-and post-test design studied 311 nursing students in the Tanga and Dodoma regions. The Standardized Patient Simulation-Based Pedagogy (SPSP) package was administered to the intervention group. Both groups underwent baseline and post-test assessments using a Interviewer-adminstered structured questionnaire as the primary data collection tool, which was benchmarked from previous studies. The effectiveness of the intervention was assessed using both descriptive and inferential statistics, specifically the Difference in Difference linear mixed model, and the t-test was carried out using IBM Statistical Package for Social Science (SPSS) software, version 25.

RESULTS

The participant's mean age was 21 years ± 2.69 with 68.81% of the students being female. Following the training Students in the intervention group demonstrated a significant increase in MSE cognition post-test, with an overall mean score of (M ± SD = 22.15 ± 4.42;p = < 0.0001), against (M ± SD = 16.52 ± 6.30) for the control group.

CONCLUSION

A significant difference exists in the levels of cognition, among nursing students exposed to Mental Status Evaluation (MSE) materials through Standardized Patient Simulation-Based Pedagogy (SPSP) embeded with lectures. When MSE materials are delivered through SPSP along with lectures, the results are significantly superior to using lectures pedagogy alone.

Midwives' perspectives about using individualized care plans in the provision of immediate postpartum care in Uganda; an exploratory qualitative study

INTRODUCTION

Individualized care planning has been slowly integrated into practice in Uganda with minimal documentation of how the concept is applied in providing care. This study explored the perceptions of midwives about the use of individualized care plans (ICPs) in the provision of immediate postpartum care.

METHODS

An exploratory descriptive qualitative approach was used in this study. We interviewed fifty midwives from 37 health facilities in Uganda's greater Mpigi region. The midwives, who were certificate and diploma holders, were purposively enrolled in the selected facilities. Deductive content analysis was done based on the COM-B model.

RESULTS

Four themes emerged from the data namely; compatibility, motivation, opportunities, and the midwives' suggested strategies and targets for improved individualized care planning. The midwives were aware of individualized care planning and they utilized it in their provision of immediate postpartum care especially when assessing clients for risks, preparing clients for referral, caring for Human Immunodeficiency virus (HIV) exposed babies and their mothers, and educating/ supporting first-time mothers (automatic motivation). Having a good nurse-patient relationship, privacy, and ample time to care for the clients were noted as motivators for individualized care plan use, while poor documentation of care, high patient load, and perceived patients' lack of understanding of the complexities of illness in the immediate postpartum period were the barriers (social opportunity) identified by midwives to the use of individualized care planning.

CONCLUSION

There are still capability, motivation, and opportunity hindrances to the use of individualized care planning. Staff recruitment, training, and harmonization of the documentation forms may improve the use of care plans in the postpartum period.

Psychometric testing of the nurse professional competence scale Arabic version: An exploratory and confirmatory factor analyses

AIM

To translate the Nurse Professional Competence Scale-Short Form English version into Arabic and psychometrically validate its properties among Saudi citizen nurses.

BACKGROUND

Evaluating nurses' professional competence is vital in delivering safe, cost-effective care and developing healthcare systems. However, psychometrically reliable and validated nurse competence scales in Arabic-speaking countries remain scant.

DESIGN

A descriptive cross-sectional design adhering to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

METHODS

Participant nurses (n = 598) were conveniently recruited from four government-owned hospitals and completed the Arabic-translated 35-item Nurse Professional Competence Scale-Short Form. We used Spearman's rank-order correlation, exploratory factor analysis, Kaiser-Meyer-Olkin test, and confirmatory factor analysis to analyze the data.

RESULTS

After exploratory factor analysis and reliability analyses, several items of the Arabic-translated 35-item Nurse Professional Competence Scale-Short Form were omitted due to high inter-item correlations and low factor loading difference. The Arabic version of the Nurse Professional Competence Scale-Short Form was reduced to 21 items, consisting of a three-factor structure: Professional Care Pedagogics, Holistic Value-Based Care, and Direct Nursing Care. Results also demonstrated that the revised three-factor structure had good overall scale reliability, good subscale internal consistencies, and acceptable construct validity using the confirmatory factor analysis.

CONCLUSION

The 21-item Nurse Professional Competence Scale-Short Form Arabic version is a useful scale, having demonstrated construct validity and reliability. Therefore, nurse managers in Arabic-speaking nations could assess their nurses' professional competence using the 21-item Nurse Professional Competence Scale-Short Form Arabic version to develop proactive programs that enhance professional competence.

Development and psychometric testing of a competency of nursing process questionnaire

Objectives

This study aimed to develop and evaluate a competency of nursing process questionnaire (CNPQ) for registered nurses in Cambodia.

Methods

Guided by the nursing process, an initial questionnaire was generated through focus group discussion, literature review, and the expert consultation. Finally, the validity and reliability of the questionnaire were validated through a questionnaire survey online of 260 registered nurses selected from Complimentary Package Activities 1, 2, 3, and national hospitals from January to February 2022 in five geographic areas of Cambodia.

Results

The content validity index was 1.00. The Cronbach's α coefficient for the whole questionnaire was 0.963, and the range for the five dimensions was 0.963-0.964, which shows that the questions were consistent. The test-retest reliability was 0.769. The exploratory factor analysis led to a list of 24 items that were grouped into five dimensions: assessment, diagnosis, planning, implementation, and evaluation. The cumulative variance contribution rate was 70.08%.

Conclusions

The CNPQ developed in this study showed good reliability and validity and can be used to assess the competency of registered nurses by themselves and help nursing managers to develop the relevant policies.

Health professionals' routine practice documentation and its associated factors in a resource-limited setting: a cross-sectional study

OBJECTIVES

Documenting routine practice is significant for better diagnosis, treatment, continuity of care and medicolegal issues. However, health professionals' routine practice documentation is poorly practised. Therefore, this study aimed to assess health professionals' routine practice documentation and associated factors in a resource-limited setting.

METHODS

An institution-based cross-sectional study design was used from 24 March up to 19 April 2022. Stratified random sampling and a pretested self-administered questionnaire were used among 423 samples. Epi Info V.7.1 and STATA V.15 software were used for data entry and analysis, respectively. Descriptive statistics and a logistic regression model were employed to describe the study subjects and to measure the strength of association between dependent and independent variables, respectively. A variable with a p value of <0.2 in bivariate logistic regression was considered for multivariable logistic regression. In multivariable logistic regression, ORs with 95% CIs and a p value of <0.05 were considered to determine the strength of association between dependent and independent variables.

RESULTS

Health professionals' documentation practice was 51.1% (95% CI: 48.64 to 53.1). Lack of motivation (adjusted OR (AOR): 0.41, 95% CI: 0.22 to 0.76), good knowledge (AOR: 1.35, 95% CI: 0.72 to 2.97), taking training (AOR: 4.18, 95% CI: 2.99 to 8.28), using electronic systems (AOR: 2.19, 95% CI: 1.36 to 3.28), availability of standard documentation tools (AOR: 2.45, 95% CI: 1.35 to 4.43) were statistically associated factors.

CONCLUSIONS

Health professionals' documentation practice is good. Lack of motivation, good knowledge, taking training, using electronic systems and the availability of documentation tools were significant factors. Stakeholders should provide additional training, and encourage professionals to use an electronic system for documentation practices.

The need for integration nursing theories into pressure ulcer care in the community

Pressure ulcers are injuries to the skin requiring integrated care, particularly when patients are at home. Pressure ulcers have been a nursing concern for years, and several strategies have been proposed for its prevention and management. Nursing theory, which is essential for nursing practice, recommends plausible approaches to health problems. However, literature describing steps to integrate nursing theory into pressure ulcer care has not yet been explored. For this reason, this article discusses the six steps on how to apply nursing theory in community practice. A case study is also discussed to help gain a better understanding of these steps.

Guideline and Implementation of Osteosarcoma Nursing Care for Children and Adolescents

Clinical trials on pediatric oncology use therapeutic techniques with the overwhelming majority of children's cancer patients obtaining therapy via clinical investigation procedures. Medical treatment is scheduled according to a specific protocol for enrolled patients. These protocols often do not refer to nursing care. Nursing care, on the other hand, must complement the medical care specified in the medical research protocol. Safe treatment administration, assessment of treatment responses, patients' and families' education, and communication with the whole medical team are just a few of the critical nursing tasks that should be properly managed. Nursing care standards have been developed in this study to strike a good balance between the procedure for clinical research and the nursing care connected with it. These recommendations outline the nursing activities and considerations that must be made while caring for pediatric cancer patients who are engaged in a specific clinical investigation procedure. The objective of this study is to outline the procedure through which nursing care guidelines could be developed and evaluated. The goal of this study was to find out the involvement of nurses in the process of health education for osteosarcoma and family patients.

Best Nursing Intervention Practices to Prevent Non-Communicable Disease: A Systematic Review

Objectives: To explore nursing health education interventions for non-communicable disease patients.

Methods: The design was a systematic review of research work published between 2008 and 2018. The data sources included the Web of Science, PubMed, Scopus, COCHRANE, and LILACS. The studies that met the inclusion were assessed, and the analysis for methodological quality through the recommended tools CASPe, and JADAD.

Results: Fifteen original studies from eight counties were included in the review; Findings revealed 13 studies with randomized samples and six used power analysis. Nurses’ interventions included house calls, home care, and individual and group health education.

Conclusion: Nursing interventions showed 76.4% the effectiveness of results in patient outcomes to promote and improve healthier lifestyles and quality of life of non-communicable disease patients. This review discloses the significant impact of nursing health education interventions. Nursing leadership and political decision-makers should consider providing programs to enhance health education knowledge and abilities. All of this can favor the sustainability of the global economy by changing the life style of thousands of people worldwide.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42020208809.

Nursing Process in Primary Care: perception of nurses

OBJECTIVES

to understand the perception of Primary Health Care nurses about the application of the Nursing Process.

METHODS

this is a qualitative, descriptive study. Data was collected through semi-structured interviews with Primary Health Care nurses from a city in the interior of the state of São Paulo, analyzed by Content Analysis under the theoretical framework of Work Process.

RESULTS

three categories were obtained: Extrinsic factors to the Nursing Process; Intrinsic factors to the Nursing Process; and Knowledge.

FINAL CONSIDERATIONS

the nurses considered the Nursing Process relevant for the profession, but historical, political, and social issues related to nursing, and health, as well as conflicts regarding its concept and academic training, hinder its application.

The Effect of Peer Teaching on the Quality of Report Writing Based on the Nursing Process

Background

Considering the importance of report writing and its problems, different teaching methods can be used to improve nurses' knowledge and performance, among which is peer teaching. This study aimed to determine the effect of peer teaching on the quality of report writing based on the nursing process.

Materials and Methods

This quasi-experimental study examined 60 nurses working in the surgical and cardiac wards of Razavi Hospital in Mashhad during 2019. These wards randomly assigned to intervention (n = 30) and control (n = 30) groups. For 2 weeks, report writing teaching was implemented for the intervention group based on the nursing process through peer teaching. The control group routinely performed report writing. At the beginning and end of the study, we reviewed nursing reports of both groups using a valid and reliable checklist. Data were analyzed using two-way analysis of variance with repeated-measures analysis of variance.

Results

Before the intervention, there was no significant difference between the two groups in terms of scores of report writing quality in structure, content dimensions, and the total scores (p > 0.05). After the intervention, the mean score changes were significantly higher in the structure (Mean Difference (MD) = 4.99, 95%CI: 1. 26-8.72, p < 0.010), content (MD = 8.11, 95%CI: 4.91-11.31, p < 0.001), and the total quality of report writing (MD = 7.54, CI: 4.56-10.53, p < 0.010) in the intervention group than the control group.

Conclusions

Peer teaching improved the nurses' quality of report writing. The teaching planners are recommended to use this method to train nursing staff.

Processo de Enfermagem na Atenção Primária: percepção de enfermeiros

RESUMO Objetivos: compreender a percepção dos enfermeiros da Atenção Primária à Saúde sobre a aplicação do Processo de Enfermagem. Métodos: estudo qualitativo, descritivo. Os dados foram coletados por entrevistas semiestruturadas com enfermeiros da Atenção Primária à Saúde de uma cidade do interior do estado de São Paulo, analisados pela Análise de Conteúdo sob o referencial teórico de Processo de Trabalho. Resultados: obtiveram-se três categorias: Fatores extrínsecos ao Processo de Enfermagem; Fatores intrínsecos ao Processo de Enfermagem; e Saber. Considerações Finais: os enfermeiros consideraram o Processo de Enfermagem relevante para a profissão, mas questões de ordem histórica, política e social relativas à enfermagem e à saúde, bem como conflitos quanto ao seu conceito e à formação acadêmica, dificultam sua aplicação.

Using Newly Developed Software to Enhance the Efficiency of the Nursing Process in Patient Care: A Randomized Clinical Trial

The nursing process is a systematic decision-making method of problem-solving that increases the quality of patient care. Implementation of modern technology in nursing can reduce documentation time, make nursing care safer, and improve the quality of patient care. This study aimed to determine the effectiveness of applying newly developed nursing process software on the efficiency of the nursing process in patient care. In this randomized clinical trial, 80 nursing students were randomly allocated into intervention (n = 40) and control (n = 40) groups. The student in the intervention group used the software to care for patients for two semesters. Students in the control group used routine hospital protocol to care for their patients. Modified Brooking nursing process measuring scale was used to evaluate the effectiveness of software before and after the intervention. The results showed a statistically significant difference in the mean efficiency score of the nursing process in the two groups after the intervention (P < .001). Using nursing process software leads to increasing the efficiency of the nursing process in patient care. Thus, providing executive support and electronic resources with relevant training for nursing students can be beneficial in students' education and be a practical application of the nursing process in caring for patients.

Evaluation of Nurses' Perceptions of Nursing Diagnoses and Their Opinions Regarding the Application of Nursing Process

AIM

This study aimed to evaluate nurses’ perception of nursing diagnoses and their opinions regarding the application of nursing process and to determine the factors affecting them.

METHOD

This was a descriptive cross-sectional study. The sample consisted of 320 nurses who worked at a foundation university hospital between October and December 2017. The Nurse’s Information Form and Nursing Diagnoses Perception Scale were used to collect the research data. The scale included expressions reflecting nurses’ perceptions about the use, usefulness, aims, results, objectives, and limitations of nursing diagnoses.

RESULTS

A total of 51.2% of the nurses participating in the study had a bachelor’s degree, and the average age was 25.36 ± 4.83 years. More than half of the nurses (50.9%) stated that they had difficulty in the assessment stage of the nursing process and that they diagnosed the risk of infection most frequently (74.4%). The nurses’ mean total score on the survey was 2.68 ± 0.44 (2–4). There was a statistically significant relationship between the total mean score of the scale with the sex, education level, and the belief that the nursing process should be used (p < .001; p < .001; p < .05).

CONCLUSION

The nurses’ perception of nursing diagnoses was at a moderate level. Positive perception of nursing diagnoses could improve nursing quality by enabling nurses to focus on care.

The implementation of nursing process during patient care in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Nursing process (NP) is a standard method of ensuring individualized holistic care through systematic assessment, diagnosis, planning, intervention and evaluation of patients. Its standard implementation is mandatory to meet the health target of "ensuring universal quality health-care services" in the sustainable development goals (SDG) launched by World Health Organization (WHO) in 2015. Being a member state of WHO, Ethiopia endorsed the SDG agenda. Therefore, determining the recent pooled estimate and associated factors of NP implementation during patient care would be of greatest importance to improve the quality of nursing care in the country.

METHODS

Primary studies were systematically searched from PubMed, Scopus, Cochrane Library, Google Scholar, PsycINFO and CINAHL data bases using different search operators. Each selected primary study was critically appraised using the Joanna Briggs Institute (JBI) appraisal tool for prevalence studies. I2 and Q statistics were used to investigate heterogeneity. Given the substantial heterogeneity between the studies, random effects meta-analysis model was used to estimate the pooled magnitude of NP implementation. Subgroup analyses were performed for evidence of heterogeneity. Egger's test was considered to declare publication bias objectively. The PRISMA guideline was followed to report the results.

RESULTS

A total of 17 primary studies with a sample of 2,819 nurses were included in this meta-analysis. The pooled estimate of NP implementation in Ethiopia was 50.22% (95% CI: 43.39%, 57.06%) with severe statistical heterogeneity (I2 = 93.0%, P < 0.001) between the studies. From regional subgroup analysis, NP was least implemented in Tigray region 35.92% (95% CI: 30.86%-40.99%, I2 < 0.001%). Egger's test showed no statistical significance for the presence of publication bias (P = 0.23). Nurses' good knowledge of NP [(Adjusted Odds Ratio (AOR) = 13.16: 9.17-17.15], nurses' Bachelor of Science (BSC) and above level of education (AOR = 4.16; 2.32-5.99), working in a stressful environment (AOR = 0.10; -0.02-0.22), training access (AOR = 3.30; 1.79-4.82) and accessibility of facility required for NP (AOR = 6.05; 3.56-8.53) were significantly associated with NP implementation at 95 % CI.

CONCLUSIONS

It was found that only half of the nurses in Ethiopia implemented NP during patient care. Fortunately, its associated factors were modifiable. Therefore, the existing national efforts of increasing nurses' knowledge of NP and their level of education, availing facilities required for NP implementation, training access and ensuring non stressful working environment should be reinforced to meet the quality nursing care demand in Ethiopia.

PROSPERO ID

CRD42019138159.

Use of Standardized and Non-Standardized Tools for Measuring the Risk of Falls and Independence in Clinical Practice

(1) Background: The use of standardized tools is regarded as the basis for an evidence-based assessment. The tools enable monitoring of complex events and the effectiveness of adopted interventions. Some healthcare facilities use standardized tools such as the Morse Fall Scale, but many use non-standardized tools created based on patient needs. Our study question was, why are non-standardized tools used when standardized tools are more beneficial and can be statistically evaluated and compared to other results; (2) Methods: We used a quantitative, non-standardized questionnaire to survey 1200 nurses, which was representative sample for the entire Czech Republic. All questionnaires were assessed in two phases (a) the frequency evaluation and descriptive analysis, and (b) hypotheses testing and correlation analyses; (3) Results: We found that the Conley Scale, Barthel test, and IADL test were preferred by many nurses. Furthermore, we found that nurses using standardized assessment scales noticed risk factors significantly more frequently but regarded the increased complexity of care to be psychologically demanding. (4) Conclusions: In patients with physical disabilities, both types of tools (internal non-standardized and standardized) are used to assess the risk of falls and independence; nurses generally welcomed the increase use of standardized tools in their facilities.

Barriers to implementation of nursing process in South Gondar Zone Governmental hospitals, Ethiopia

Background

The nursing process is a global concept, which forms the foundation of nursing as a profession. The use of the nursing process in most hospitals is lagging despite all the efforts of nursing professionals to implement it. The nursing process is dynamic and it is used in clinical practice worldwide to deliver quality-individualized care to patients.

Objective

This study assessed barriers to the implementation of the nursing process among nurses working at South Gondar Zone Governmental Hospitals, North Central Ethiopia, 2019.

Methods

Institutional based cross-sectional study was carried out. By using Census about N = 249 nurses were recruited. Data was collected through self-administered questionnaires. The data were entered into Epi data version 3.1 and analyzed using statistical package for social sciences (SPSS) version 23.0. Descriptive statistics such as measurements of central tendency and inferential statistics multiple logistic regression, 95% CI, and p-value ≤ 0.05 was used. The study was approved by Debre Tabor University college of health sciences ethics and research committee.

Results

A total of N = 249 study subjects participated with the response rate of 241 (96.4%). The mean age (SD±) of respondents' was 29.9 ± 7.2. About two-third of 146 (60%) nurses had poor knowledge of nursing process implementation. Three fourth 180 (74.7%) of nurses were implementing the nursing process. Nurses with sufficient information to NP were 2.45, nurses who have adequate skills to NP were 2.43, and nurses who have good knowledge were 2.24 times more likely to implement the nursing process than the opposite. No enough motivation to use NP 137 (56.8%), no follow-up by authority 141 (58.5%), no enough time for applying NP 145 (60.2%), no specific training for applying NP 173 (71.8%) and shortage of nurse staffs for nursing NP implementation 187 (77.6%) are also factors which affects nursing process implementation.

Conclusion

Based on this study only three fourth of the nurses were implementing the nursing process. For poor and non-implementation of nursing process different hindering factors were identified. Such as; shortage of time, lack of training, lack of knowledge, unrecognized by authority, no enough motivation, lack of cooperation b/n professionals, engaging in other manual tasks and unrelated tasks, unclear and poor job descriptions, work overload and poor payment for the profession were the major barriers for NP implementation. Therefore, there need to be strengthen national policy frameworks and interventions aimed at improving nursing process training and implementationin in the clinical settings.

Attitude of nursing students following the implementation of comprehensive computer-based nursing process in medical surgical internship: a quasi-experimental study

Background

The nursing process is the core and the standard of practice in nursing profession. Nowadays, the use of information technology in the field of nursing processes, education and practice has been emphasized. Since nurse’s attitudes towards clinical information systems are considered as an indicator of the success rate of information systems, and nurse’s attitudes about the nursing process can affect their execution of the process. So the purpose of this study was to evaluate nursing students’ attitudes towards the nursing process software.

Methods

In this quasi-experimental study, 160 undergraduate nursing students (terms 4–8) in Tabriz University of Medical Sciences were selected by convenience sampling. To evaluate the effectiveness of nursing process software in this study, Mazlom and Rajabpoor (IJME 14(4):312–322, 2014) a questionnaire consisting of 21 components based on a five-point Likert scale was completed by students after using the software. Data were then analyzed by SPSS 19 software.

Results

The mean score of students’ attitude toward nursing process software was high (80.70 ± 5.58). The nursing students’ highest scoring attitudes were respectively related to “Effectiveness of software in prioritizing patient care and problems”, “Completeness of patient’s electronic information compared to handwritten mode” and “Software’s effectiveness in saving your time”. The lowest scoring attitudes towards the software was respectively related to the “feeling of fairness in labor division”, “the effectiveness of the software in determining your workload” and “the feeling of satisfaction in labor division”. There was a statistically significant relationship between gender and age, and student’s attitude toward nursing process software.

Conclusions

According to the results and analysis of nursing student’s attitudes toward nursing process software, the use of such software would be welcomed by students. It seems that changing policies in the educational and clinical substructure of nursing in order to develop, adapt and use the nursing process software is an important responsibility for nursing authorities to consider. Providing educational and clinical technology equipment, periodic evaluation of software by stakeholders and promoting the use of this software, can be fundamental steps in operationalizing the findings of this research.

Healthcare-associated infection and its determinants in Ethiopia: A systematic review and meta-analysis

Background

Healthcare-associated infection is a global threat in healthcare which increases the emergence of multiple drug-resistant microbial infections. Hence, continuous surveillance data is required before or after patient discharge from health institutions though such data is scarce in developing countries. Similarly, ongoing infection surveillance data are not available in Ethiopia. However, various primary studies conducted in the country showed different magnitude and determinants of healthcare-associated infection from 1983 to 2017. Therefore, this systematic review and meta-analysis aimed to estimate the national pooled prevalence and determinants of healthcare-associated infection in Ethiopia.

Methods

We searched PubMed, Science Direct, Google Scholar, and grey literature deposited at Addis Ababa University online repository. The quality of studies was checked using Joanna Brigg’s Institute quality assessment scale. Then, the funnel plot and Egger’s regression test were used to assess publication bias. The pooled prevalence of healthcare-associated infection was estimated using a weighted-inverse random-effects model meta-analysis. Finally, the subgroup analysis was done to resolve the cause of statistical heterogeneity.

Results

A total of 19 studies that satisfy the quality assessment criteria were considered in the final meta-analysis. The pooled prevalence of healthcare-associated infection in Ethiopia as estimated from 18 studies was 16.96% (95% CI: 14.10%-19.82%). In the subgroup analysis, the highest prevalence of healthcare-associated infection was in the intensive care unit 25.8% (95% CI: 3.55%-40.06%) followed by pediatrics ward 24.16% (95% CI: 12.76%-35.57%), surgical ward 23.78% (95% CI: 18.87%-29.69%) and obstetrics ward 22.25% (95% CI: 19.71%-24.80%). The pooled effect of two or more studies in this meta-analysis also showed that patients who had surgical procedures (AOR = 3.37; 95% CI: 1.85–4.89) and underlying non-communicable disease (AOR = 2.81; 95% CI: 1.39–4.22) were at increased risk of healthcare-associated infection.

Conclusions

The nationwide prevalence of healthcare-associated infection has remained a problem of public health importance in Ethiopia. The highest prevalence was observed in intensive care units followed by the pediatric ward, surgical ward and obstetrics ward. Thus, policymakers and program officers should give due emphasis on healthcare-associated infection preventive strategies at all levels. Essentially, the existing infection prevention and control practices in Ethiopia should be strengthened with special emphasis for patients admitted to intensive care units. Moreover, patients who had surgical procedures and underlying non-communicable diseases should be given more due attention.

The burden of healthcare-associated infection in Ethiopia: a systematic review and meta-analysis

Background

Different primary studies in Ethiopia showed the burden of nosocomial infection across geographical setting and variant period. However, the national level of burden and types of healthcare-associated infections were unknown. Hence, this systematic review and meta-analysis estimated the overall nationwide burden and types of healthcare-associated infections in Ethiopia.

Methods

We searched PubMed, Science Direct, Google Scholar, African Journal Online, and Addis Ababa University repository by date April 7, 2020. To assess publication bias, Egger’s test regression analysis was applied. Weight-inverse random-effect model meta-analysis was used. Subgroup analysis was conducted based on ward type, study region, study design, sample size and diagnostic method, ward type, and study participants.

Results

A total of 18 studies with 13,821 patients participated in the overall prevalence estimation. The pooled prevalence of healthcare-associated infection was 16.96% (95% CI 14.10–19.82). Specifically, surgical site infection (39.66%), urinary tract infection (27.69%), bloodstream infection (19.9%), dual infections (SSI and UTI) (14.01%), and respiratory tract (13.51%) were the commonest types of healthcare-associated infection. In subgroup analysis, the highest overall prevalence was observed as surgical, gynecology, and obstetrics ward (22.42%).

Conclusions

The national prevalence of healthcare-associated infection remains high. The most common type of HCAI was surgical site infection, followed by urinary tract infection, bloodstream infection, SSI and UTI, and respiratory tract infection. The overall prevalence was highest in surgical, gynecology, and obstetrics ward. Hence, infection prevention and control should be a priority agenda in healthcare with due emphasis for surgical patients.

Implementation of Nursing Process and Its Association with Working Environment and Knowledge in Ethiopia: A Systematic Review and Meta-Analysis

Background

The nursing process is a scientific problem-solving approach, which directs nursing care and potentially improves quality of health care service. The national pooled implementation of the nursing process in Ethiopia remains unknown. Hence, this review and meta-analysis aimed to estimate the overall implementation of the nursing process and its association with the working environment and knowledge in Ethiopia.

Methods

PubMed, Scopus, Cochrane Library, Google Scholar, PsycINFO, and CINAHL were searched and complemented by manual searches. The DerSimonian and Laird random effects model was applied to estimate the pooled effect size, odds ratios, and 95% confidence interval across studies. The I² statistic was used to check heterogeneity between the studies. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. Publication bias was examined using funnel plot and Egger's regression test statistic. Analysis was performed using STATA™ Version 14 software.

Results

Seven studies comprised of 1,268 study participants were included in this meta-analysis. The estimated pooled implementation of the nursing process in Ethiopia was 42.44% (95% CI: 36.91, 47.97%). Based on subgroup analysis, methods of outcome measurement showed that the highest overall implementation of the nursing process was observed from studies conducted using self-report technique 42.95% (95% CI: 35.76, 50.15). Nurses working in stressful environment were 81% less likely to implement the nursing process (OR 0.19, 95% CI: 0.04, 0.76), and nurses having good knowledge were 8 times more likely to implement nursing process (OR 8.38, 95% CI: 2.82, 24.86).

Conclusion

The overall implementation of the nursing process in Ethiopia was relatively low. Good knowledge of nurse had paramount benefits to improve implementation of the nursing process. Therefore, nurse can be educated on the imperative of knowledge in order to enhance the nursing process implementation and to improve the overall quality of healthcare services. Furthermore, policymakers and other concerned bodies should give special attention to improving the implementation of the nursing process.

Nursing diagnosis identification by nurses in burn wards: A descriptive cross-sectional study

Aim

To identify and document patients' care needs, it is vital to provide quality care services. This study was aimed to describe care needs derived from records of patients with burn and to evaluate whether nurses employed the North American Nursing Diagnosis Association classification to formulate patients' care needs.

Design

A descriptive cross-sectional study.

Methods

In this study using the convenient sampling method, 430 nursing records reviewed in the burn wards. Data were collected using Gordon's checklist. The validity of the checklist assessed by content validity and the reliability of them calculated with inter-rater and internal consistency. Data analysed by SPSSv.24.

Results

The mean number of diagnoses per record was 1.94. The most frequent diagnosis was in the domain of Safety/Protection and the top two prevalent nursing diagnoses in Sina hospital were a risk for infection and risk for falls. From all of the detected diagnostic, about 83% were determinedly not related to one of 247 labels of the North American Nursing Diagnosis Association. Given that nurses provide nursing care as requested by physicians and patient care needs are not assessed and recorded by them, it can be concluded that there was no nursing thinking behind their nursing care.

The implementation of the nursing process in lower-income countries: An integrative review

Aims

This review study aimed to investigate the strategies for implementing the nursing process in the clinical practice and the assessment of the implementation rate of this process in clinical settings of lower-income countries.

Design

An integrative review.

Method

The search was conducted of EMBASE, MEDLINE, CINAHL, Scopus and ISI databases from 1975-July 2018. Following the formation of the research team, two researchers independently selected the eligible studies; finally, 39 articles were approved by the research team for this study.

Results

The researchers identified three themes: Effects of implementing the NP in clinical settings, Development and application of electronic software in the NP and Factors affecting the implementation of the NP. This review revealed that nurses and nursing managers in hospitals are interested in implementing the nursing process in the form of widely and continuously. But the necessary infrastructure, such as manpower, electronically or manually tools, has not yet been provided, and the implementation of the nursing process is done either imperfectly or not done.